The present invention relates to nutritional formulations for the support and therapy of individuals. More specifically, the present invention relates to nutritional compositions for supporting and/or providing therapy to individuals at risk and/or under treatment for atherosclerotic, vascular, cardiovascular, or thrombotic diseases.
For some time investigators and scientists have noted a relationship between diet and the heart function and related systems. There has always been an appreciation for the cardiovascular effects of obesity and the recognition of widespread prevalence of under nutrition in hospitalized patients with cardiovascular derangements. Accordingly, there have been many attempts to formulate nutritional support for patients at risk for or exhibiting atherosclerotic, vascular, cardiovascular, and/or thrombotic diseases. Poindexter, et al, Nutrition in Congestive Heart Failure, Nutrition In Clinical Practice (1986) recognize that specific nutritional deficiencies may cause, precipitate, or aggravate acute heart failure. As Poindexter, et al, point out, nutritional deficiencies have been significant factors in the etiology of heart failure in the Orient and developing countries. It is further noted that nutritional therapy for malnourished cardiac patients in recent years has been considered essential supportive therapy.
Patients suffering from long term congestive heart failure have been found to suffer from cardiac cachexia. Other effects of protein-calorie malnutrition on the heart include hypertension, reduced heart rate, reduction in basal metabolic rate and oxygen consumption, atrophy of the heart muscle mass, electrocardiogram (ECG) abnormalities, and heart failure. Furthermore, when congestive heart failure occurs secondary to valvular heart disease that is treated surgically, nutritional status has a notable effect on the surgical outcome. Performing cardiac surgical procedures on patients in a state of nutritional depletion can result in increased morbidity and mortality, compared to adequately nourished patients.
Typically, patients suffering from congestive heart failure are underweight with poor nutritional status. Patients with congestive heart failure and cardiac cachexia frequently exhibit anorexia and early satiety. Poindexter, et al, state that this is attributed to the natural compensatory mechanism that decreases work of the failing heart. Furthermore, due to hepatic congestion that increases pressure in the abdominal cavity, there is a constant feeling of fullness. Moreover, altered taste sensations and intolerances to food odors limit the patient's desire to eat. Accordingly, liquid nutritional supplements high in nutrient density are desirable. However, as Poindexter notes, this must be tempered with concern about the complications caused by overzealous refeeding of malnourished cardiac patient.
Not only are patients with congestive heart failure and other vascular diseases typically underweight with poor nutritional status, but their energy requirements are greatly in excess of a normal individual's energy requirements. Poindexter, et al, note that energy requirements of a patient with congestive heart failure may be 30-50 percent in excess of basal energy expenditure because of increased cardiac and pulmonary energy expenditure. Indeed, cachectic patients require additional calories for repletion and post-operative cardiac patients require still further increases in caloric intake to meet energy demands. For example, the protein requirement for a normal healthy individual to maintain zero nitrogen balance is 0.5-1.0 g/Kg. The patient with congestive heart failure or the postoperative cardiac patient in contrast can require as much as 1.5-2.0 g/Kg to maintain nitrogen balance.
Not only is nutrition important in treating the patient with atherosclerotic, vascular, cardiovascular, and/or thrombotic disease but it is also important in supporting patients at risk of acquiring these diseases Diet can impact the onset of these diseases in certain individuals.
Accordingly, there is a need for a nutritional composition for supporting and therapeutically treating individuals under treatment for vascular, cardiovascular, or thrombotic diseases. Moreover, there is a need for a nutritional composition for supporting individuals who are at high risk of atherosclerotic, vascular, cardiovascular, and/or thrombotic disease.